Obama Administration Lied About Insurance Company Bailouts

A Damning Report

By: Dan McLaughlin (Diary)  |  August 5th, 2014 at 02:00 PM – RedState

It can be difficult to keep track of all the untruths the Obama Administration has told in the process of selling Obamacare to a disbelieving public, and it is tempting to write these all off as history, more than four years later. But the untruths have never stopped coming. A House oversight report released last week reveals that the Administration has been misleading the public about the likelihood that it will have to bail out insurance companies that sold policies under Obamacare. I highly recommend you read both the report and Jeffrey Anderson’s excellent story in the Weekly Standard summarizing it, as well as Phil Kerpen’s blow-by-blow of the emails over at The Federalist. The upshot is that, even after the Administration’s hard sell and coercive mandates forced millions of Americans to buy policies from the big health insurance companies, we should expect a billion-dollar bailout of those companies because the mix of people buying them is older and sicker than projected (unexpectedly!), and we should expect going forward to face a choice between premium increases and even bigger bailouts.

The Oversight Report covers a variety of close contacts between the Administration and the insurance companies, which in and of themselves are an eye-opening up-close look at corporatism in action and the sheer hypocrisy of an Administration that loves to bash insurers publicly while working hand in glove with them and catering to their needs behind the scenes – an Administration where, by President Obama’s own account, he commonly asks CEOs why they aren’t spending more of their shareholders’ money lobbying for his policies on immigration, the environment and education. The quid pro quo in that arrangement is that Administration carrot-and-stick control over the big insurers has kept many of them publicly on the reservation, parroting pro-Obamacare talking points and shying away from public criticism, all so that the Administration can tout their silence as proof the program’s critics are all wet. There’s only so much you can blame the insurers, who after all are for-profit companies that by now have no real choice but to do business with Leviathan. But we’ve come a long way from the idealistic “new politics” rhetoric of 2008 to the grubby details of bailing out big corporations from a mess entirely of this President’s own making.

 

The bailouts are at the heart of this web of deceit. Pre-Obamacare, insurers had to price their policies mainly by reference to market forces (albeit in an already heavily-regulated market): charge enough to cover the actuarial cost expected for each enrollee, but not too much to lose business. Guess wrong and you lost money. But under Obamacare, consumers no longer have the choice whether or not to buy policies, and insurance companies no longer face any risk of losing money, because they’ve been promised a bailout. Money will still be lost, but it will be taxpayer money, and you never run out of that, do you?

Obamacare Enrollees Older and Sicker Than Projected

Obamacare has three separate programs (the “3Rs”) that make up this bailout: Reinsurance, which pays companies to subsidize particular policies; the Risk Corridor program, which taxes companies that end up with less-expensive mixes of policyholders and subsidizes those that have more-expensive mixes; and the Risk Adjustment program, which does the same at the insurance plan level. The mechanics of these are all more complex than that (but trust them, they have top men working on all these details), but the general idea is that, if Obamacare works as projected, the Reinsurance program will provide a subsidy of up to $20 billion over the next three years, but the other two programs will be budget-neutral. In other words, there will be an equal balance of winners and losers subsidizing their fellow comrades in glorious workers’ paradise without pestering the taxpayers.

But the data provided by the insurers – insurance companies and co-ops covering about 80% of the market, from which the overall numbers are extrapolated* – makes clear that the Administration’s public stance of no-net-bailouts is at odds with what those insurers expect and have been telling the White House:

As of May 2014, twelve of the 15 traditional health insurers expect to receive payments from the Risk Corridor program, one of the insurers expects to make payments into the Risk Corridor program, and two insurers expect no net payments. These 15 insurers project they will receive approximately $640 million in net payments through the Risk Corridor program for the 2014 plan year.

As of May 2014, of the 23 co-ops, seven expect to receive payments from the Risk Corridor program, two expect to make payments into the Risk Corridor program, and 14 expect no net payments. These 23 co-ops expect to receive approximately $86 million in net payments through the Risk Corridor program for the 2014 plan year.

…Although the Risk Adjustment program is required to be budget neutral, many more insurers expect to receive payments than make payments. As of May 2014, the companies surveyed by the Committee expect net payments through the Risk Adjustment program of about $346 million. Moreover, insurers expect to receive nearly twice as much in net Risk Adjustment payments than they did on October 1, 2013. This provides additional evidence that insurers expect enrollees in ObamaCare-compliant plans to be less healthy than originally anticipated. In fact, enrollment information provided by insurers show that insurers enrolled a much older risk pool, on average, in their ObamaCare-compliant plans than they anticipated.

While the exchange plans were always susceptible to adverse selection because of how expensive the law made insurance for younger and healthier individuals, several delays and modifications to the law by the Obama Administration worsened the adverse selection problem….Insurers directly lobbied the White House for the Administration to make the 3R programs more generous to insurers, and the Administration obliged. Insurers and co-ops now expect a third more from the Risk Corridor taxpayer bailout than they did on October 1, 2013. It is impossible to know how much of the increase in the industries’ expectation for the size of the bailouts is the result of a less healthy exchange population than originally anticipated and how much of the increase is from the Administration’s rule changes to make the bailouts more generous…

This is, as the Oversight Report notes, dramatically different from the February 2014 CBO analysis that Democrats uniformly trumpeted as evidence that there would be no net bailout; the House went straight to the insurers because “the CBO estimates were inconsistent with widespread sentiment among actuaries and health policy experts”. The actual insurance company data paints a picture quite different from the CBO’s report, in part because (as set forth in the graph at the top of this post), the mix of enrollees has turned out to be older and likely sicker than projected, mainly due to a drastic shortfall in the enrollment of families with children (always a demographic overlooked by this Administration). In other words, as usual, reality has failed to conform to the assumptions provided to the CBO. As the report notes:

The large increase in insurers’ expectations for Risk Corridor payments and Risk Adjustment payments between October 1, 2013, and the present are consistent with recent media reports about a high degree of adverse selection in exchange plans. An April report from Express Scripts, a pharmacy benefits manager, showed that early exchange plan enrollees were spending much more money on drugs than individuals in group plans. On June 24, 2014, the Wall Street Journal reported that exchange enrollees are about 70 percent more likely to have significant health issues than people enrolled in the individual market in 2013. According to an analysis of the early claims data, healthy individuals largely chose to keep their existing non-ObamaCare-compliant plans while those with greater health concerns have opted for exchange coverage. Patrick Getzen, chief actuary for Blue Cross Blue Shield North Carolina, told the Wall Street Journal, “[i]t’s even worse than what we thought. … We’re seeing more chronic conditions than we would have expected.”

The Committee has obtained two pieces of information that further demonstrate that people enrolled in exchange plans are significantly older and less healthy than initially expected by insurers. The first is that insurers anticipate much larger payments through ObamaCare’s Risk Adjustment program than they did on October 1, 2013. The second is that insurers have reported to the Committee that they have enrolled a substantially older population in their exchange plans than they projected prior to October 1, 2013.

Obama White House Is Warned But Downplays The Risk

The Oversight Report details the communications between insurance company executives concerned about potential mounting losses and Valerie Jarrett and other White House officials who were eager to keep them singing from their script, and who eventually agreed to a more generous bailout package in order to tamp down pressure to raise rates even further than planned. Anderson summarizes a key exchange:

[T]he administration declared that the risk-corridor program would be budget-neutral. In reply, according to the Oversight report, CareFirst Blue Cross Blue Shield CEO Chet Burrell emailed Jarrett and then talked on the phone with her later that same day. The next day, he emailed her again, attaching a memo that said, “Until very recently, the position of the Administration had been that the law requires the Federal government to fully fund the Risk Corridor payments if amounts paid in by the ‘winners’ turn out to be inadequate — as they likely will.’” Otherwise, he added, “carriers will have to increase rates substantially (i.e., as much as 20% or more beyond what they would otherwise file) to make sure that premiums adequately reflect expected costs.” In other words, the administration had a choice: provide a bailout, or face the unpleasant prospect of having insurers price their products honestly.

…Soon thereafter, the Obama administration abandoned the claim of budget-neutrality, writing in a release from Health and Human Services (HHS), “In the unlikely event of a shortfall for the 2015 program year, HHS recognizes that the [Patient Protection and] Affordable Care Act requires the Secretary to make full payments to issuers. In that event, HHS will use other sources of funding for the risk corridors payments, subject to the availability of appropriations.”

So, the Administration was continuing to call a bailout “unlikely” as insurance company CEOs were warning the White House that the industry believed it was in fact “likely,” and were pressuring the White House to guarantee a bailout precisely for that reason. As the Oversight Report details, the expected bailout has increased significantly since the October 2013 launch of Obamacare, and now tops $1 billion. And as Anderson details, there is no way Congress will appropriate money for such a bailout, and the Administration’s basis for claiming it can be funded without an appropriation is exceptionally shaky. But then, this White House won’t be stopped by such minutuae as Article I, Section 9 of the Constitution.

Rate Hikes A-Comin’

All of this matters because rate hikes are on their way, and the bailout appears to be the only thing holding them back from getting even worse. We just saw the Florida insurance regulators project a 13% increase in premiums for 2015, some of which will hit policyholders and the rest of which will – like the bailout – be absorbed by taxpayers. This is in line with other states as well:

According to officials in the State of California, insurance premium increases in the first year of the Affordable Care Act (ACA), also known as Obamacare, ranged from 22 percent to 88 percent….According to press reports, they will rise by an average of 15 percent in Indiana, 12 percent in New York, 11 percent or more in Arizona, 11 percent in Iowa, 5 percent in Delaware…by double digits in Tennessee and Louisiana, and as much as 15 percent in Virginia. More and more states are likely to announce rate increases in the weeks ahead.

The Administration’s fear of unpopular rate hikes seems to have motivated the bailout, as the insurers were pointedly warning Jarrett that she needed to move to reassure them on bailouts before the next set of deadlines for publicly filing their next year’s rates. There’s an election coming, after all.

As the Oversight Report notes, even with all of this governmental support, a number of the co-ops and at least a few insurance companies seem to be underpricing policies in a way that will be unsustainable and lead to ever-growing demands for bigger bailouts down the road, creating a fiscal death spiral for the program:

[T]axpayers appear to be on the hook for bailing out co-ops that significantly underpriced their plans in 2014. Moreover, policyholders with coverage through these co-ops should expect large premium increases in future years when the co-ops can no longer rely on taxpayers to heavily subsidize their revenues.

In addition to the co-ops, many other insurers also appear to have underpriced exchange plans for the 2014 plan year, likely due to their expectation of receiving a taxpayer bailout. The Committee has learned that, as of October 1, 2013, many large insurers expected to receive payments through the Risk Corridor program. Of the 15 insurers, six expected payments through the Risk Corridor program prior to the start of open enrollment while none expected to make payments into the Risk Corridor program.

Obamacare is the gift that keeps on giving – from you to a big industry that President Obama only pretends to hate.

* – The Oversight Report’s estimates are based on the White House’s frequently touted figure of seven million Obamacare enrollees, although it expresses skepticism about that as well, see page 15 of the Report.

The Absence of Obamacare Credits in Federal Exchanges WAS INTENTIONAL – Designed to Force Compliance

By Tom White  –  VA Right  -  Cross-Posted at Ask Marion:Two recent court cases came to two different conclusions in the battle against Obamacare. The question was concerning the language of the bill when it comes to credits in Health Care Exchanges set up by the Federal Government when states decide not to set up State Health Care Exchanges.

The language is pretty clear in the fact that it does create credits for Exchanges set up by the states. These credits are substantial and are the only part of the entire Affordable Care Act that actually addresses affordability. Sadly, this is done by redistributing the wealth. By taxing the productive earners in order to subsidize non-productive earners.

Monthly premiums for silver plans – the standard insurance policy sold on the exchanges – cost an average of $345 a month this year for people who did not qualify for subsidies, a new analysis from the administration shows.  – See more at: http://www.thefiscaltimes.com/Articles/2014/06/18/Average-Obamacare-Subsidy-3312-Paid-Date-47-Billion#sthash.OQTugto5.dpuf

According to The Fiscal Times:

Monthly premiums for silver plans – the standard insurance policy sold on the exchanges – cost an average of $345 a month this year for people who did not qualify for subsidies, a new analysis from the administration shows.

However, for the overwhelming majority of Obamacare enrollees (87 percent) who did qualify for financial assistance, the average monthly premium on the silver plan costs about $69. That’s an average tax credit of about $276 a month, or $3,312 a year. The administration’s report broke down the average monthly premium for each of the four plans offered on the federal marketplace – before and after tax credits. It also detailed the percentage of enrollees selecting each plan, with or without tax credits. Data was not available for the state exchanges, which make up about one third of the total 8 million enrollees.

On average, monthly premiums after subsidies run about $69.00. But without the subsidy, $345.00. And 87% of enrollees qualify for these huge subsidies.

So with all the mandates for coverage, mandates on what must be covered and what can be charged, it is the subsidies and the subsidies alone that make the product affordable. Without them, the cost of Health Insurance rises considerably due to mandatory expanded coverages.

The Affordable Care Act depends on states setting up Exchanges as called for in the law. However, when much of the law was in the process of being written, it was done in secret. No one knew exactly what was going into the mix and the authors were as yet unaware of the massive resistance the bill was about to encounter. But they anticipated at least some token resistance from the rascally Republican controlled states. And this expected resistance was addressed in the bill with various sneaky political weapons and landmines designed to nudge resistive states into setting up the exchanges.

One political weapon the Democrats love to use is abortion. Republicans are outraged when tax dollars are confiscated to pay for a procedure they consider infanticide. So one of the booby traps the architects of Obamacare used was abortion. This would be the first of several “lesser of two evils” options resistive Republican states would face in deciding to implement Obamacare. You may recall the Stupak Amendment that extended the Hyde Amendment wording that prevents the Federal Government from paying for abortions. There was a big argument in House over abortion and several pro life Democrats insisted that the ACA not pay for abortions as a condition of casting their vote for the bill. However, that was the House Bill which was scrapped after Scott Brown’s victory effectively cut off the Democrat’s super majority in the Senate.

The Conservative Intelligence Briefing put it this way:

Recall that after the special election of Sen. Scott Brown, R-Mass., in January 2010, Democrats were suddenly deprived of the flexibility they had expected to have in drafting the law’s provisions. They had expected a House-Senate conference committee in which they could iron out the kinks in the law and then pass it again through both the House and Senate. But suddenly, after Brown won, they realized they would never be able to pass any version of Obamacare through the Senate again. They no longer had the 60 votes they needed.

So the Democrats did the only thing they could: They took the version of the law they had already passed through the Senate on Christmas Eve 2009, and rammed it back through the House, warts and all. There was no second chance to consider this issue or any others in detail. In any event, most members had only a vague idea of what the bill did anyway.

- See more at: http://www.conservativeintel.com/the-briefing-vol-ii-issue-25/?utm_source=Intel&utm_medium=email&utm_campaign=House#sthash.tC38djHj.dpuf

Recall that after the special election of Sen. Scott Brown, R-Mass., in January 2010, Democrats were suddenly deprived of the flexibility they had expected to have in drafting the law’s provisions. They had expected a House-Senate conference committee in which they could iron out the kinks in the law and then pass it again through both the House and Senate. But suddenly, after Brown won, they realized they would never be able to pass any version of Obamacare through the Senate again. They no longer had the 60 votes they needed.

So the Democrats did the only thing they could: They took the version of the law they had already passed through the Senate on Christmas Eve 2009, and rammed it back through the House, warts and all. There was no second chance to consider this issue or any others in detail. In any event, most members had only a vague idea of what the bill did anyway.

- See more at: http://www.conservativeintel.com/the-briefing-vol-ii-issue-25/?utm_source=Intel&utm_medium=email&utm_campaign=House#sthash.tC38djHj.dpuf

Recall that after the special election of Sen. Scott Brown, R-Mass., in January 2010, Democrats were suddenly deprived of the flexibility they had expected to have in drafting the law’s provisions. They had expected a House-Senate conference committee in which they could iron out the kinks in the law and then pass it again through both the House and Senate. But suddenly, after Brown won, they realized they would never be able to pass any version of Obamacare through the Senate again. They no longer had the 60 votes they needed.

So the Democrats did the only thing they could: They took the version of the law they had already passed through the Senate on Christmas Eve 2009, and rammed it back through the House, warts and all. There was no second chance to consider this issue or any others in detail. In any event, most members had only a vague idea of what the bill did anyway.

So the truth is, there is no language in the Senate Bill itself that prevents the Federal Government from paying for abortions. And in order to get the pro life Democrats to vote for the Senate version of Obamacare, Obama issues an executive order #13535 that pretends to forbid Federal payment of abortion. None of the pro life groups were fooled, nor were the voters in Stupak’s District in Michigan. Stupak “retired” and the voters put a Republican in the seat.

But according to Wiki, there are incentives to entice states into setting up these Exchanges:

Under the law, setting up an exchange gives a state partial discretion on standards and prices of insurance, aside from those specifics set-out in the ACA. For example, those administering the exchange will be able to determine which plans are sold on or excluded from the exchanges, and adjust (through limits on and negotiations with private insurers) the prices on offer. They will also be able to impose higher or state-specific coverage requirements—including whether plans offered in the state are prohibited from covering abortion (making the procedure an out-of-pocket expense) or mandated to cover abortions that a physician determines is medically necessary; in either case, federal subsidies are prohibited from being used to fund the procedure. If a state does not set up an exchange itself, they lose that discretion, and the responsibility to set up exchanges for such states defaults to the federal government, whereby the Department of Health and Human Services assumes the authority and legal obligation to operate all functions in these federally facilitated exchanges.

And if having more control and discretion on the policies offered in each state isn’t enough to convince states to implement Obamacare, the Democrats added a big hammer. The Federal Government will come in and run things, leaving the states no say in how health care policies are sold in the state. Take that, you Republicans.

This Youtube video is a recording of the chief architect of the Senate Obamacare bill. The guy who put the political plums and hemlock in the bill, Jonathan Gruber. It is clear from listening to him speak that the intent was to use the lack of subsidies in the Federally run Exchanges as a mechanism to force states into compliance.

Video: Jonathan Gruber Once Again Says Subsidies Are Tied to State-Based Exchanges

But Gruber said that this was a mistake. A speak-o (as opposed to a typo). The intent was always to have the Federally run Exchanges give out the subsidies!

There is a video here that is nearly an hour long that has been making the rounds on the internet. I edited the same video down to about 5 minutes with the important parts being about the first 2 minutes. The rest of this is some pretty revealing comments Gruber made on the longer version.

Video:  Jon Gruber Condense Version

So it is abundantly clear that the intent was to use the lack of subsidies in the Federally run exchanges to pressure states into compliance.

So in the two recent court decisions in direct opposition to one another as FoxNews explains:

WASHINGTON –  Two federal appeals court rulings put the issue of ObamaCare subsidies in limbo Tuesday, with one court invalidating some of them and the other upholding all of them.

The first decision came Tuesday morning from a three-judge panel of the U.S. Court of Appeals for the District of Columbia. The panel, in a major blow to the law, ruled 2-1 that the IRS went too far in extending subsidies to those who buy insurance through the federally run exchange, known as HealthCare.gov.

A separate federal appeals court — the Fourth Circuit Court of Appeals — hours later issued its own ruling on a similar case that upheld the subsidies in their entirety.

The conflicting rulings would typically fast-track the matter to the Supreme Court. However, it is likely that the administration will ask the D.C. appeals court to first convene all 11 judges to re-hear that case.

In both instances the government argued that it is obvious that the intent was to include federal subsidies in the Federally run Exchanges if the states refused to do so. But listening to the guy that wrote the bill, the exact opposite is the case. The subsidies were left out on Federally run Exchanges to use as a weapon to either force Republican governors to implement a state exchange or face the voters to explain why they are paying more for health insurance and get no subsidies. The hope of this Democratic bill was to force Republicans to do something they did not want to do.

Now one of the arguments I have not heard made is that on the issue of abortion on Federally run Exchanges. One of the incentives for the Liberal states to jump in and implement exchanges is the ability to mandate expanded coverages such as 100% payment for abortions. And if we follow the same logic the government argued in the two conflicting ruling cases, that the Federal Government steps in and is essentially considered the state for all intents and purposes – something I find preposterous – then what is to stop the Federal government who suddenly finds itself a surrogate for the state from mandating abortion coverage (from Wiki linked above):

Under the law, setting up an exchange gives a state partial discretion on standards and prices of insurance, aside from those specifics set-out in the ACA. For example, those administering the exchange will be able to determine which plans are sold on or excluded from the exchanges, and adjust (through limits on and negotiations with private insurers) the prices on offer. They will also be able to impose higher or state-specific coverage requirements—including whether plans offered in the state are prohibited from covering abortion (making the procedure an out-of-pocket expense) or mandated to cover abortions that a physician determines is medically necessary;

So if the federal government can come in and replace the state in every way, then the same argued consideration as far as subsidies would extend to the other areas of “partial discretion” of the states. And the law could then go around the Obama executive order prohibiting federal funds from paying for abortion.

This must go to the Supreme Court and the 36 states without state run subsidies must stop receiving federal subsidies.

And as Gruber says in the long version of the video, repeal is unlikely to get rid of Obamacare. But neglect in the form of non compliance will cause it to implode in on itself. He uses a 3 legged as an example. The legs are eliminate pre existing conditions, insurance mandates and subsidies. Take away one of the legs and the law collapses. No one is fighting the pre existing condition elimination and the horrific Supreme Court ruling that held the mandates were a tax (and thus constitutional) is gone as a possible tool to kill the law. The last remaining leg is the subsidies. Without them, the law cannot survive. And since 36 states refused to set up exchanges, this is a huge threat to Obamacare’s survival.

With more and more information being unearthed every day about this bill, this is an important battle in the war on healthcare being prosecuted by the Obama Administration.

Update:

My theory is that if the Court rules that Federal Exchanges are essentially State Exchanges for the purpose of the subsidies, then the Feds are, essentially, the state. States are free to mandate abortion coverage, the Feds are not by Executive order. So if the Federal Government becomes a state for subsidies, then the Feds can mandate abortion coverage and also get around the Exec. Order.  Tom White

OpEd: Real Healthcare Reform Should Focus On Care, Not Just Coverage

O-Care’s one-size-fits-all failure

By: Nancy Pfotenhauer  -  The Hill  -  May 8, 2016

Many lawmakers on both sides of the aisle agree that universal health insurance is the central goal of a successful health care reform. The left sold the Affordable Care Act to the American people on this promise; the right hopes to do the same with an alternative plan set to be unveiled later this year.

Both sides are trying to fix the wrong problem. Universal health insurance is profoundly different from better health care—and so long as reformers focus on the former, the latter will continue to deteriorate.

Real healthcare reform must improve the quality of America’s healthcare system. At its most fundamental level, healthcare exists to improve individuals’ health outcomes and overall well-being. Beneficial reforms will thus improve those outcomes, increase healthcare’s quality and lower its costs, with the ancillary effect of expanding its availability.

This is a more worthy goal than putting a health insurance card in everyone’s hand, a la ObamaCare and its Republican replacements. Universal health insurance is merely the provision of a service regardless of that service’s quality. This cannot be achieved without the assistance of a massive bureaucratic apparatus in Washington that stifles innovation, limits consumer choice and increases its costs. Thus, reforms that seek universal health insurance decrease healthcare’s quality, and they don’t deliver on their promise to make coverage universal.

Better healthcare will not be realized without unleashing market-driven innovation. Reformers can’t pretend that this existed prior to Obama-Care’s passage. Then, as now, federal regulations hemmed in consumers and innovators on every side. ObamaCare’s mandates only expand this restrictive regulatory regime.

Innovators and consumers should be unshackled from the reams of red tape. This starts by putting patients—not bureaucrats or insurance companies—at the center of health care. Patients must be free to choose a health plan that is tailored to their needs, not one with benefit mandates created by special interests. Patients need access to real-time health care provider data that doesn’t hide costs or quality behind an impenetrable wall of bureaucratic regulations. Patients should be empowered to improve their own health using breakthrough technologies and personalized treatments.

Thus free to choose, consumers will seek out products and services that actually fit their needs. Innovators will concurrently strive to develop treatments and health care options that consumers want—and at a price they can afford.

No one-size-fits-all federal policy can accomplish this goal.

For instance, several state and federal laws prevent innovators and consumers from working together. So, multiple policy proposals targeting these barriers should be considered and challenged. 

National Center for Policy Analysis President John Goodman’s ideas about improving the poor’s access to care can be coupled with Cato Institute Director of Health Policy Studies Michael Cannon’s ideas about getting prices closer to consumers. Sen. Tom Coburn’s (R-Okla.) idea about equalizing the tax treatment of insurance policies can be one of a number of policies, along with Rep. Steve Scalise’s (R-La.) and Rep. Tom Price’s (R-Ga.) slightly different approaches. Economist John Cochrane has proposals to help those with pre-existing conditions; Bob Graboyes, a senior research fellow at George Mason University, details how we can unleash healthcare innovation. And ideas by the likes of Rep. Paul Ryan (R-Wis.), Louisiana Gov. Bobby Jindal (R), Wisconsin Gov. Scott Walker (R), and many others all have promise.

Every proposal should be judged by whether it leads to better healthcare for individuals and families, not whether it gives them a health insurance plan they don’t want or can’t afford. Until this shift happens, the country’s healthcare system will continue to serve Washington’s whims rather than Americans’ well-being. 

Pfotenhauer is the president of MediaSpeak Strategies and a senior adviser with Freedom Partners, a nonprofit advocate for free-market policy.

Technorati Tags: ObamaCare,Healthcare Reform,Health Insurance,Universal Healthcare,Wake-Up,Socialized Medicine,ObamaCare Surprises,Repeal and Replace ObamaCare

The Coming Two-Tiered Medical System

Scott W. Atlas, writing at the Wall Street Journal (Cross-Posted at the Razor), warns about the coming two-tiered medical system.

About one-third of primary-care physicians and one-fourth of specialists have already completely closed their practices to Medicaid patients. Over 52% of physicians have already limited the access that Medicare patients have to their practices, or are planning to, according to a 2012 survey by Merritt Hawkins for the Physicians Foundation. More doctors than ever already refuse Medicaid and Medicare due to inadequate payments for care, and that trend will only accelerate as government lowers reimbursements.

In order to cut costs insurance plans are narrowing their networks, removing access to the best hospitals in the country (including Barnes Hospital in my hometown.)

For cancer care, the overwhelming majority of America’s best hospitals in the National Comprehensive Cancer Network—including MD Anderson Cancer Center of Houston, New York’s Memorial Sloan-Kettering, Barnes Hospital in St. Louis, and the Seattle Cancer Care Alliance uniting doctors from Fred Hutchinson Cancer Research Center, UW Medicine and Seattle Children’s—are not covered in most of their states’ exchange plans.

Elements of this are already in place. The best paying jobs on physician job boards are “closed practices” run by large companies for their employees, or concierge practices that do not accept insurance.

Meanwhile, concierge practices are increasing rapidly, as patients who can afford it, along with many top doctors, rush to avoid the problems of an increasingly restrictive health system. The American Academy of Private Physicians estimates that there are now about 4,400 concierge physicians, 30% more than last year. In a recent Merritt Hawkins survey, about 7% to 10% of physicians planned to transition to concierge or cash-only practices in the next one to three years. With doctors already spending 22% of their time on nonclinical paperwork, they will find more government intrusion under ObamaCare regulations taking even more time away from patient care.

Moving towards socialized medicine inevitably leads to a two-tiered system. Having lived for 5 years under socialized medicine in Japan, I’ve seen the both tiers, and the quality of care diverged significantly between them to the point where we chose a private hospital for the birth of The Kid. The only question will be whether the quality of care good enough for the vast majority of Americans, or the care will stagnate and decline as the best and brightest health care providers move into the higher-paying private practices and hospitals.

Technorati Tags: ObamaCare,Socialized Medicine,Wake-Uprisings,Doctor Shortages,Medicaid

It’s Official: The IRS Will Raid Your Tax Data Through Obamacare

“Surprise, Surprise, Surprise!” as Gomer Pyle used to say… except for those who read the bill… and exactly why they have been working so hard to wake America up.

So, it is official, the IRS will be getting personal data from the healthcare exchanges in order to help it implement Obamacare… And as Americans continue to be corralled into a government-mandated healthcare plan, it will be even more difficult to protect personal data.   (AP Photo/J. David Ake, File)

The Blaze: The Internal Revenue Service this week will publish a final rule requiring Obamacare health insurance exchanges to hand over key personal data to the IRS, which will use the information to implement the tax aspects of the controversial health care law.

The IRS rule covers health exchanges that sell insurance to individuals, and it takes effect this year. That means people enrolled in an Obamacare exchange this year will have their information given to the IRS as soon as it’s needed for tax purposes.Information to be handed over from Obamacare exchanges includes names, addresses, taxpayer identification numbers, insurance premium amounts, the name of the insurance issuer, and the insurance plan policy number issued by the exchanges.

The IRS says this data is needed to assess whether people are eligible for a health insurance tax credit. “This tax credit can help make purchasing health insurance coverage more affordable for people with moderate incomes,” according to the IRS.

The rule is being published amid ongoing concerns about data security, and after the troubled launch of the healthcare.gov website that exposed many technical glitches. Those issues have some worried that the personal data people give to the exchanges will be at risk.

House Republicans have passed a few bills aimed at addressing this potential problem. In January, for example, the House passed the Exchange Information Disclosure Act, which would require the government to tell people whenever their personal information has been compromised.

Republicans have also passed legislation requiring weekly updates from the administration on how the law is being implemented, including details about website glitches.

So far, however, only the House has passed these bills, and the Senate has not given any indication it will consider them.

The final IRS rule follows draft regulations that were issued last summer. Those rules were put out for public comment, and the final rules to be published this week were tweaked in some ways in response to those comments.

But the IRS also ignored some requests to alter the rule. For example, the draft rule said exchanges must tell the IRS whether a person enrolled in an Obamacare plan by a taxpayer is that taxpayer’s dependent. The commenter said the IRS should have that information, and that it therefore doesn’t need to be reported.

But the IRS said it would not change this rule.

“The final regulations do not adopt this comment because information the IRS provides as part of the verification process is from the taxpayer’s most recently filed tax return, which may be two years old,” the rule states.

The final IRS rule is due to be published on Wednesday.

The IRS Will Now Be Able to Seize Individual’s Personal Information Through ObamaCare

Technorati Tags: IRS-gate,ObamaCare,ObamaCare Surprises,Wake-Up,Taxes,ObamaCare Taxes,Alert

Affordable Care Act, ObamaCare, plans pose actuarial and rate challenges for insurers, rate to skyrocket in 2015

By Jay Hancock, Saturday, April 26, 3:06 PM  -  Washington Post  -  E-mail the writers

With the results sure to affect politics as well as pocketbooks, health insurers are preparing to raise rates next year for plans issued under the Affordable Care Act.

But how much depends on their ability to predict how newly enrolled customers — for whom little is known regarding health status and medical needs — will affect 2015 costs. 

Republicans have been sharply critical of the rule and of the many ways people can skirt it.

“We’re working with about a third of the information that we usually have,” said Brian Lobley, senior vice president of marketing and consumer business at Pennsylvania’s Independence Blue Cross. “We’ve really been combing the data to get a first look.”

At stake are price increases that buyers on the federal exchange, HealthCare.gov, and other online marketplaces will encounter when they get renewal notices this year. Forecasting success or failure could also affect whether insurers stay on the exchanges, a key pillar of the health overhaul.

The 2014 enrollment period closed at the end of March for most consumers. But carriers selling medical plans on HealthCare.gov must file initial 2015 rate requests with federal regulators in late May or June — even though they have little idea about the health and potential costs of their newly enrolled members. Deadlines also loom for state-run exchange filings.

WellPoint, the biggest player in the online exchanges, is talking about double-digit rate hikes for 2015. Such increases would give ammunition to Republican critics before the November elections.

Analysts’ expectations vary, but nobody is predicting decreases.

“We’ll see rate increases in the marketplaces, but I think it’s anyone’s guess” about what the precise changes will be, said Sabrina Corlette, project director at the Georgetown University Center on Health Insurance Reforms. “It’s like nailing Jell-O to a wall.”

The health law required insurers to accept all applicants this year for the first time without asking about existing illness. That reduces what they know about customers and raises the likelihood that they’ll sign sicker, more expensive members who were previously denied coverage.

At CoOportunity Health, a nonprofit carrier in Iowa and Nebraska, many enrollees scheduled medical treatments — including surgeries — as soon as possible after their coverage began Jan. 1, said chief operating officer Cliff Gold. Among the procedures were several expensive transplant operations, including heart and lung procedures that can cost more than $1 million each.

But insurers tend to receive pharmaceutical claims long before hospital bills. They are poring over these early prescription records for clues about new members’ medical status.

Pharmacy-benefit manager Express Scripts published data April 9 showing that marketplace enrollees in January and February were substantially more likely than average to have HIV infections, chronic pain, depression and other high-cost ailments.

But that doesn’t necessarily mean average costs will soar.

For one thing, insurers figured they would cover more sick patients this year and priced plans accordingly. Early pharmacy data at Independence Blue Cross, Lobley said, are “on par for what we expected.”

Even if carriers signed more chronically ill customers this year than planned, the health law includes “reinsurance” and other safety valves designed to keep high-cost members from pushing up rates.

A sign-up surge at the end of March is another reason not to rely on early claims information.

Just as the first enrollees were more likely to need immediate care, insurers think people who pushed the deadline may be healthier and younger. If so, they would balance the risk and help cover the cost of the early birds.

“It’s clear that sick people were signing up” for January coverage, said David Axene, a fellow of the Society of Actuaries working with insurers to set 2015 rates. “The question now is, were the later people healthier?”

Nobody knows. While March enrollees seem to have been younger on balance, their health status remains largely a mystery.

Blue Shield of California signed more than 50,000 people during the last two weeks of March.

“It’s still too early to draw conclusions,” said Amy Yao, Blue Shield’s chief actuary. “I have the best actuarial team in the whole country. Even with that, it’s less than 50 percent confidence” that they’ll hit the rate-setting sweet spot for 2015, she said.

It’s unclear how many of the 8 million who enrolled through the exchanges were previously uninsured. Many who did have coverage switched carriers this year, meaning their new insurers couldn’t see their health histories.

At CoOportunity Health, a start-up created with funding from the health law, every one of the 74,000 customers is new.

“It is an actuarial nightmare to try to guess what you’re going to get,” Gold said.

It’s not just member health that insurers have to think about. President Obama allowed many people to keep old plans that aren’t compliant with ACA rules. Carriers must calculate how that exception (people covered under old plans are thought to be healthier on average) affects average costs in their new policies.

Backup resources for plans with disproportionate shares of sick and expensive members will become a little weaker next year. Insurers have to factor that into their rates.

And they need to look at the big picture.

What economists call the cost trend — how high prices rise per procedure and how many procedures Americans get this year — may be the biggest variable in setting prices for 2015, experts said.

And the trend seems to be up. After several years of relatively tame increases that many tie to a sluggish economy, medical spending accelerated late last year.

Even so, the forces affecting 2015 premiums may not drive up ACA prices as much as some are forecasting. Finding that insurers have gotten discounts from select hospitals and doctors, the Congressional Budget Office recently lowered its estimate for the cost of premiums and taxpayer subsidies under the health law.

“I’m not expecting double digits like some people have predicted” for 2015 rate increases, Axene said. “I’m expecting mid-to-high single digits” — from 6 to 8.5 percent.

That would still be far higher than growth in the economy or family incomes.

Given the uncertainties that come with a major new social law, officials at Independence Blue Cross don’t think the picture will become clear until much later.

“We always viewed this as a three-year plan,” Lobley said. “We always thought there would be a lot of volatility in years one and two. We really thought 2016 would [bring] market stability in the individual market.”

Kaiser Health News is an editorially independent program of the Kaiser Family Foundation.

Related: 

2.7 Million ObamaCare Enrollees Still Unaccounted For

Aid organizations across the country were jammed with people racing to get insurance under the Affordable Care Act..

Feds prepare to take over Oregon’s health exchange

21 ACA deadline extensions, in one chart

Technorati Tags: ACA,Affordable Care Act,ObamaCare,ObamaCare Costs,Wake-Up,ObamaCare Surprises,PPACA,Insurance Exchanges,Health Insurance Providers,Kaiser

2.7 Million ObamaCare Enrollees Still Unaccounted For

President Obama speaks about the status of the Affordable Care Act in the press briefing room of the White House on April 17, 2014. -- AP View Enlarged Image

IBD - Investor's Business Daily: Affordable Care Act: President Obama has for a while been bragging that 8 million people have signed up for ObamaCare. But the administration still hasn't released the state-by-state numbers to back up that number.

You'd think that with such good news, the administration would want to put out as many details as possible, as soon as possible. But judging by previous months, the latest Health and Human Services enrollment report is now nearly two weeks behind schedule.

As a result, we still don't know where 2.7 million ObamaCare enrollees came from.

Here's what we do know:

The exchanges run by 15 states and Washington, D.C., have reported final enrollment numbers at least through March, and most have numbers through April 15. The combined total for these exchanges is 2.6 million.

For the remaining 36 states, all we have are the numbers HHS released through February. At that point, these states accounted for 2.7 million sign-ups.

Add the two together, and you get 5.3 million. That means roughly 2.7 million must have signed up in just these 36 states after March 1 to reach the 8 million mark. And that means enrollment in these states must have doubled in just the last six weeks of a 28-week open enrollment period.

To call this an incredible achievement is putting it mildly, particularly since the state-run exchanges saw enrollment climb only 62% in those final six weeks.

So where did these 2.7 million come from? We won't know until the HHS report comes out, which presumably could be any day now.

But even if Obama can account for these fantastic gains, there are still several questions that need answering.

First, of course, is: How many have paid?

Georgia says that only 48% of the 221,604 who enrolled through March 31 have paid their premiums. In South Carolina, only 59% of the 114,789 who enrolled through April 15 had done so.

Another question: Do the numbers account for people who dropped coverage earlier? We know at least some have been kicked off for nonpayment, and others canceled their plans for one reason or another. Is HHS netting out these losses, or is it simply adding new enrollment numbers on top of the old ones?

And, did the agency screen out duplicate enrollments? One broker told us that in the last month his company was encouraged to simply start a new application if something went wrong during the process, so as to speed things up. He figures 30% of the ObamaCare applications his firm handled in the home stretch were duplicates. Did these get counted in the final tally?

The mainstream media, unfortunately, have shown zero interest in trying to make sense of these numbers, much less independently verify them. Instead, they obeyed Obama's command to "move on."

But until we get more data, and get answers to these questions, we're reluctant to accept any ObamaCare numbers put out by this administration.

Technorati Tags: ObamaCare,ObamaCare Enrollment,ObamaCare Lies,ObamaCare Surprises,Manipulation,Obamaland,Spin,Accounting,Accountability

The next wave of Obamacare horror stories won't be about cancellations

C. Steven Tucker:  The last quarter of 2013 was filled with horror stories of millions of Americans – many of them Cancer patients – losing their health insurance because of the PPACA “Obamacare”. Even though Barack Obama promised “if you like your plan you can keep your plan and no one will take it away from you, period.” At the very least, many of the 6.3 million policy holders who had their coverage canceled were able to obtain a QHP – ‘qualified health plan’ – on a guaranteed issue basis (no preexisting conditions) as a replacement shortly thereafter. Albeit those plans are often times more expensive and expose those consumers to higher premiums and out of pocket risk exposure, most especially if they do not qualify for taxpayer funded ‘advance premium tax credits’-  to artificially lower premiums and ‘cost sharing’ subsidies to lower deductibles.

That was then, this is now.

The new wave of Obamacare horror stories will begin being told all across America now that we are outside of the first national ‘open enrollment’ period which ended on 3/31/2014. Only this time it won’t be about Americans losing their health insurance. It will instead be about the vast majority of Americans being unable to purchase individual, renewable health insurance from any carrier no matter how sick they are until January 1, 2015. That’s right, unlike before Obamacare when you could blame those “evil health insurance companies” for “denying you your right to health care.” Now, the blame will rest squarely on the shoulders of the greatest health insurance salesman in world history, Barack Obama.

Millions of Americans are about to be denied their ‘right‘ to health care.

It is Barack Obama’s health care law that will be directly responsible for denying millions of sick Americans their ‘right‘ to health insurance from now until January 1, 2015. From now until then Americans who wish to purchase their own individual, renewable health insurance are barred by federal law from doing so. In fact, the only way to do so now is you have a ‘qualifying life event’ and as such qualify for a ‘special enrollment’ period. Understand that the ‘qualifying life events’ listed below apply only to those who qualify for subsidies and as such can plead their case to the decision makers at Healthcare.gov. The truth is under Obamacare your ‘right’ to health care refers to beseeching yet another group of nameless, faceless government bureaucrats who may or may not let you purchase health insurance that will cover your preexisting conditions. Yeah, this is going to be great! Forward!

The rest of us in the individual market will be barred by federal law from obtaining our own health insurance that covers preexisting conditions until January 1st, 2015. It is from this pool of millions that the new horror stories will come from. Imagine you are a low information voter who doesn’t vote at the ballot box but votes for American Idol candidates every year.  Then, imagine you develop cancer or another life threatening illness in May and find out that you can’t get health insurance coverage that covers your preexisting condition for another 7 months. Yeah, 2014 is going to be a great year politically for Republicans. Not even they can screw this gift up.

       Examples of qualifying life events are:

• You move to a new area that offers you different plans, or isn’t covered by your HMO network.
• You get married.
• You have or adopt a child.
• You lose other health coverage due to job loss, a decrease in work hours, end of COBRA coverage or other reasons.
• You become a U.S. citizen.
• Your income changes, or some other event changes your income or household status.
• You can prove that your health insurance company violated its contract with you.
• You are no longer covered on a family member’s policy because you turned 26, you have legally separated from or divorced your spouse, or the policy holder has passed away.
• You become a member of an Indian tribe. Other complicated cases that may qualify for a special enrollment period
• You faced a serious medical condition or natural disaster that kept you from enrolling. For example:
  • An unexpected hospitalization or temporary cognitive disability
  • A natural disaster, such as an earthquake, massive flooding, or hurricane
  • A planned Marketplace system outage, such as Social Security Administration system outage

  Misinformation or misrepresentation Misconduct by a non-Marketplace enrollment assister (like an insurance company, navigator, certified application counselor, or agent or broker) resulted in you:

  • Not getting enrolled in a plan
  • Being enrolled in the wrong plan
  • Not getting the premium tax credit or cost-sharing reduction you were eligible for

  Enrollment error Your application may have been rejected by the insurance company’s system because of errors in reading the data, or some of the data was missing or inaccurate. System errors related to immigration status An error in the processing of applications or system caused you to get an incorrect immigration eligibility result when you tried to apply for coverage. Display errors on HealthCare.gov Incorrect plan data was displayed at the time that you selected your health plan, such as benefit or cost-sharing information. This includes issues where some consumers were allowed to enroll in plans offered in a different area, or enroll in plans that don’t allow certain categories of family relationships to enroll together. Medicaid/Marketplace transfers

  • If you applied for Medicaid through your state, or were sent to Medicaid from the Marketplace, but you weren’t eligible for Medicaid.
  • Your state transferred your information to the Marketplace but you didn’t get an answer about your eligibility and/or didn’t get enrolled before March 31.

  Error messages Your application was stopped due to specific error messages. For example, you received a “data sources down” error message or another error message that didn’t allow you to enroll. Unresolved casework You’re working with a caseworker on an enrollment issue that didn’t get resolved before March 31. Victims of domestic abuse You’re a victim of domestic abuse and weren’t previously allowed to enroll and receive advance payments of the premium tax credit separately from your spouse. You’ll be able to do so now. Other system errors Other system errors that kept you from enrolling, as determined by the Centers for Medicare & Medicaid Services

You can still buy health insurance in the individual market but it won’t cover your preexisting conditions

Nonrenewable ‘short term’ or ‘temporary’ individual health insurance policies are still available for sale but they will not cover your preexisting conditions. And, only a few health insurers are still offering them.  Some of the biggest players in the market such as Aetna and Humana are not offering temporary plans. Of the few carriers who still are, I recommend Assurant Health for unlike other carriers Assurant Health covers outpatient prescription drugs the same as any other illness. Other carriers do not. To get quotes for temporary health insurance coverage from Assurant Health click their banner below:

You will owe a non compliance ‘fine’ (TAX) to the IRS for taking the short term route

You must also understand that you will be subject to a 1% of your MAGI ‘fine’ (TAX) for purchasing temporary health insurance since these plans do not include the “essential health benefits” under Obamacare such as Maternity for 62 year old women and single men, drug rehab coverage for those who do not own a crack pipe and pediatric dental for those without children. As such temporary policies are not considered ‘qualified health plans’. Rest assured though, if you are self employed and do not over pay your taxes you will never pay that ‘fine’ (TAX) for the only recourse the IRS has to collect that fine is to hold your tax refund. All criminal penalties for non compliance were removed from the health care law prior to passage.

The other kind of health insurance that will cover preexisting conditions outside of open enrollment

The other option if you need coverage for preexisting conditions outside of open ‘enrollment’ is to purchase small group health insurance which is available to groups of two or more people.  However, you must be incorporated and take a Schedule K as an owner of the company. Also, if you are already sick the policy will be max rated and with most carriers if you are going to add employees they must be W2 employees not 1099 contractors.

Technorati Tags: ObamaCare,death panels,IRS,Taxes,PPACA Medicare,ACA

Obama reacts to adjusted ObamaCare numbers

Technorati Tags: ObamaCare,ObamaCare Lies,Obamaland

Republican senator says administration has 'cooked the books' on Obama Care numbers!!!!!

Cooked Books on ObamaCare

FoxNews.com:

A Republican senator said on Sunday that the lack of details about Obama Care enrollment numbers suggests the Obama administration has “cooked the books.”;

Sen. John Barrasso, R-Wyoming, made his comments just hours before the Monday deadline to enroll in the Affordable Care Act and was skeptical of the administration’s most recent enrollment figure of more than 6 million Americans.

“I don't think it means anything,” he told “Fox News Sunday.” “They are cooking the books on this.”;

Though the enrollment number now appears just a million shy of the administration’s goal of 7 million by the March 31 deadline, Barrasso said Americans who have switched to Obama Care from insurance deemed sub-standard under the Affordable Care Act still don’t know whether they can keep their same doctors. And they don’t know whether their premiums will indeed be more affordable.

Among the other questions are whether enough younger people have enrolled in Obama Care to cover the health care costs of older Americans in the program and how many of those enrolled previously were uninsured.

Maine Sen. Angus King, Independent, said on the show that the enrollment number is now at 6.5 million and that “signups are getting younger every day.”;

However, he acknowledged the administration needs to be more forthcoming about the numbers, as Americans rely on third-party analysis to get much of their information.

“I do think there’s a transparency problem,” said King, adding he would be willing to work on legislation to fix such problems.

Said Barrasso: “I’ve looked at this 10 different ways. This health care law is unfixable.”;

THE PATRIOT FROM FLORIDA… MARCH 30, 2014:

**DID OBAMA LIE TO THE AMERICAN PEOPLE?

WILL OBAMA GIVE FREE OBAMACARE TO FELONS IN PRISON?

WILL OBAMA GIVE FREE OBAMACARE TO ILLEGAL IMMIGRANTS?

IS IT TRUE OBAMA PROMISSED IMMIGRANTS THAT HE WILL NOT DEPORT THEIR RELATIVES AND THEY BUY OBAMACARE?

WILL OBAMA BE USING CHRISTIAN TAX MONEY TO KILL BABIES?

IF OBAMA LIED TO THE AMERICAN PEOPLE, OBAMA MUST BE IMPEACHED

68% of the country does not want Obamacare….

NO OBAMA CARE FOR OBAMA, NO OBAMA CARE FOR ME!

Technorati Tags: ObamaCare,Lies,Wake-Up,Barrasso,Repeal and Replace ObamaCare,Affordable Care Act,Obamaland

Obamacare Navigator: 'No One Really Has to Pay a Penalty'

An Obamacare navigator tells the Chicago Tribune that the much-feared Obamacare penalty is not something most people should worry about.

Breitbart: The Tribune says Community Counseling Centers of Chicago navigator Tim van Alstyne said, "he tells people that between the state's broader Medicaid options (thanks to its decision to expand the program) and the available tax credits, 'no one really has to pay a penalty.'" 

The government says that Americans who choose to opt-out of Obamacare must pay a fine of $95 or 1% of their modified adjusted household income, depending on which is higher.

The original March 31 Obamacare deadline has now been extended until mid-April and will be run on the "honor system" for those who claim they tried but were unable to enroll before the deadline--a direct reversal of assurances embattled Health and Human Services Secretary Kathleen Sebelius gave members of Congress during congressional testimony.

Obamacare remains deeply unpopular. The RealClearPolitics average of polls finds that just 39% of Americans now support President Barack Obama's signature legislative achievement. 

Technorati Tags: ObamaCare,Navigators,ObamaCare Surprises,Penalties,Wake-Up,Sebelius,Obamaland,Polls

Ezekial Emanuel Is Really Looking Forward To The Demise of Insurance Companies

The Reaper Curve: Ezekiel Emanuel used the above chart in a Lancet article to illustrate the ages on which health spending should be focused. "Principles for Allocation of Scarce Medical Interventions" The Lancet, January 31, 2009 making way for death panels as part of his system and part of the ObamaCare plan!

PJ Tatler: Ezekial Emanuel, the brother of Rahm Emanuel and former health care adviser to President Obama, is just salivating at the thought of the demise of health insurance companies. Why, he’s downright gleeful.

Ezekial Emanuel, brother of Chicago mayor and former Obama staffer Rahm Emanuel, is cheerily predicting that Obamacare will bring about the death of the private insurance companies in the US. Ezekiel makes the provocative prediction in the New Republic.

Emanuel writes that Obamacare is already causing insurance companies to either die or evolve into something else. “The good news is you won’t have insurance companies to kick around much longer,” he writes.

Obamacare was not sold to the American people as a means of destroying private health insurance companies or even forcing them into turning into a different type of company. It was sold as a means of bringing insurance costs down while increasing access. It has turned out to cause about 6.2 million Americans to lose their insurance while forcing some Americans to buy insurance or pay a fine to the IRS. “If you like your healthcare, you can keep your healthcare,” President Barack Obama repeatedly promised. Emanuel’s article provides more evidence that the president was knowingly lying, and that people like Emanuel, who were close advisers while Obamacare was being written, knew that it would cause chaos for millions of Americans and their insurance.

Emanuel writes that Obamacare is already causing some medical services providers to seek exclusive contracts with employers, cutting insurance plans out but also limiting the choices available to customers.

Ezekiel has consistently predicted, after Obamacare became law, that it would kill insurance companies. While Obamacare was being debated, Democrats denied that its purpose was to destroy private health insurance companies. Emanuel claims, without providing any evidence, that Americans will be happier in the new employer-based health provider networks.

“So be prepared to kiss your insurance company good-bye forever,” Emanuel concludes at the end of the article.

About 85% of Americans were happy with their healthcare before Obamacare.

It’s really no secret that the Democrats’ plan all along was single payer. Some just aren’t willing to admit it.

Update: Emanuel appeared on Morning Joe talking about how great Obamacare is doing. He didn’t, however, mention his glee at the coming demise of the insurance companies. 

He also did not mention his creepy ‘Complete Lives System’. In 2009 Betsy McCaughey warned about Obama’s Health Rationer-in-Chief and now we are standing at the door…

Cross-Posted at AskMarion

Technorati Tags: ObamaCare,The Plan,Ezekial Emanuel,Single-Payer,Wake-Up,Big Brother,Evil,Insurance Exchanges,Health Insurance Companies,ObamaCare Surprises,IRS,Complete Lives System,Czars,Obamaland

Stephen Blackwood: ObamaCare and My Mother's Cancer Medicine

The news was dumbfounding. She used to have a policy that covered the drug that kept her alive. Now she's on her own.

WSJ: When my mother was diagnosed with carcinoid cancer in 2005, when she was 49, it came as a lightning shock. Her mother, at 76, had yet to go gray, and her mother's mother, at 95, was still playing bingo in her nursing home. My mother had always been, despite her diminutive frame, a titanic and irrepressible force of vitality and love. She had given birth to me and my nine younger siblings, and juggled kids, home and my father's medical practice with humor and grace for three decades. She swam three times a week in the early mornings, ate healthily and never smoked.

And now, cancer? Anyone who's been there knows that a cancer diagnosis is terrifying. A lot goes through your mind and heart: the deep pang of possible loss (what would my father and all of us do without her?), and the anguish and anger at what feels like injustice (after decades of mothering and managing dad's practice, she was just then going back to school).

We, as a family, were scared and angry, but from the beginning we knew we would do all we could to fight this disease. We became involved with fundraising for research, through the Caring for Carcinoid Foundation in Boston; we blogged; we did triathlons (my mother's idea) and cherished our time together as never before.

Carcinoid, a form of neuroendocrine cancer, is a terminal disease but generally responds well to treatment by Sandostatin, a drug that slows tumor growth and reduces (but does not eliminate) the symptoms of fatigue, nausea and gastrointestinal dysfunction. My mother received a painful shot twice a month and often couldn't sit comfortably for days afterward.

Getty Images

As with most cancers, one thing led to another. There have been several more surgeries, metastases, bone deterioration, a terrible bout of thyroiditis (an inflammation of the thyroid gland), and much more. But my mother has kept fighting, determined to make the most of life, no matter what it brings. She has an indomitable will and is by far the toughest person I've ever met. But she wouldn't still be here without that semimonthly Sandostatin shot that slows the onslaught of her disease.

And then in November, along with millions of other Americans, she lost her health insurance. She'd had a Blue Cross/Blue Shield plan for nearly 20 years. It was expensive, but given that it covered her very expensive treatment, it was a terrific plan. It gave her access to any specialist or surgeon, and to the Sandostatin and other medications that were keeping her alive.

And then, because our lawmakers and president thought they could do better, she had nothing. Her old plan, now considered illegal under the new health law, had been canceled.

Because the exchange website in her state (Virginia) was not working, she went directly to insurers' websites and telephoned them, one by one, over dozens of hours. As a medical-office manager, she had decades of experience navigating the enormous problems of even our pre-ObamaCare system. But nothing could have prepared her for the bureaucratic morass she now had to traverse.

The repeated and prolonged phone waits were Sisyphean, the competence and customer service abysmal. When finally she found a plan that looked like it would cover her Sandostatin and other cancer treatments, she called the insurer, Humana, HUM -2.81% to confirm that it would do so. The enrollment agent said that after she met her deductible, all treatments and medications—including those for her cancer—would be covered at 100%. Because, however, the enrollment agents did not—unbelievable though this may seem—have access to the "coverage formularies" for the plans they were selling, they said the only way to find out in detail what was in the plan was to buy the plan. (Does that remind you of anyone?)

With no other options, she bought the plan and was approved on Nov. 22. Because by January the plan was still not showing up on her online Humana account, however, she repeatedly called to confirm that it was active. The agents told her not to worry, she was definitely covered.

Then on Feb. 12, just before going into (yet another) surgery, she was informed by Humana that it would not, in fact, cover her Sandostatin, or other cancer-related medications. The cost of the Sandostatin alone, since Jan. 1, was $14,000, and the company was refusing to pay.

The news was dumbfounding. This is a woman who had an affordable health plan that covered her condition. Our lawmakers weren't happy with that because . . . they wanted plans that were affordable and covered her condition. So they gave her a new one. It doesn't cover her condition and it's completely unaffordable.

Though I'm no expert on ObamaCare (at 10,000 pages, who could be?), I understand that the intention—or at least the rhetorical justification—of this legislation was to provide coverage for those who didn't have it. But there is something deeply and incontestably perverse about a law that so distorts and undermines the free activity of individuals that they can no longer buy and sell the goods and services that keep them alive. ObamaCare made my mother's old plan illegal, and it forced her to buy a new plan that would accelerate her disease and death. She awaits an appeal with her insurer.

Will this injustice be remedied, for her and for millions of others? Or is my mother to die because she can no longer afford the treatment that keeps her alive?

Like every American, I want affordable health care, and I'm open to innovative solutions of all kinds—individual, corporate, for-profit, nonprofit and public. It will take all of these, and all the intelligence, creativity and self-discipline we have, as well as everything we can offer one another as families, neighbors, friends and citizens—and it still won't be perfect. But it is precisely because health care for 300 million people is so complicated that it cannot be centrally managed.

The "Affordable" Care Act is a brutal, Procrustean disaster. In principle, it violates the irreducible particularity of human life, and in practice it will cause many individuals to suffer and die. We can do better, and we must.

Mr. Blackwood is the president of Ralston College, a planned liberal-arts institution in Savannah, Ga., and is on the board of the Caring for Carcinoid Foundation. His mother, Catherine, manages the Family Medicine Center in Virginia Beach, Va.

Technorati Tags: Cancer,ObamaCare,Wake-Up,ObamaCare Surprises,Socialized Medicine,Carcinoid,Neuroendocrine Cancer,ObamaCare Casualties,Obamaland

Fourth Georgia hospital closes due to Obamacare payment cuts

DailyCaller: The fourth Georgia hospital in two years is closing its doors due to severe financial difficulties caused by Obamacare’s payment cuts for emergency services.

The Lower Oconee Community Hospital is, for now, a critical access hospital in southeastern Georgia that holds 25 beds. The hospital is suffering from serious cash-flow problems, largely due to the area’s 23 percent uninsured population, and hopes to reopen as “some kind of urgent care center,” CEO Karen O’Neal said.

Many hospitals in the 25 states that rejected the Medicaid expansion are facing similar financial problems. Liberal administration ally Think Progress has already faulted Georgia for not expanding Medicaid as Obamacare envisioned.

But the reality is more complicated. The federal government has historically made payments to hospitals to cover the cost of uninsured patients seeking free medical care in emergency rooms, as federal law mandates that hospitals must care for all patients regardless of their ability to pay.

Because the Affordable Care Act’s authors believed they’d forced all states to implement the Medicaid expansion, Obamacare vastly cut hospital payments, the Associated Press reports.

The Supreme Court ruled that states could reject the Medicaid expansion in 2012, as part of the decision that upheld Obamacare generally. Since that decision, the Obama administration has so far instituted 28 unilateral delays and changes to the health care law’s implementation without congressional approval, Fox Business reports.

From verifying eligibility for subsidies to enforcing employer requirements, the Obama administration has already taken a hacksaw to the health care reform law, but it has made no changes to the provision raising problems for half the nation’s hospitals.

While the feds wait for financial pressure to force states to act, several state governments have been taking things into their own hands. Some have criticized these moves as “hospital bailouts.”

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Technorati Tags: ObamaCare,Medicaid,Hospitals,Georgia

Emilie’s Story: ObamaCare is hurting people like me

Video: Emilie’s Story: ObamaCare is hurting people like me

Here is comment I received from a gal, a reader of mine named Emmie over at AskMarion.  Neither of these women are alone or exceptions… their situations are repeated hundreds of times daily…

I wanted to contact you privately but cannot find an email address for you anywhere. So I will write here and hope you see it.

I was all for healthcare reform because I found it unacceptable that so many Americans were unable to get it. This sounded like a good thing. So I tried to allay the fears of people like you whenever I heard concerns being raised. Boy, was I ever played!

I am currently between jobs. Cobra will run me about $500 a month – more than half of my mortgage. Not an option. Okay, I’ll go through healthcare.gov and see what they have to say. Well, that will run me more than $300 a month. Unemployment won’t garner me enough money to consider this and I’m not poor enough to qualify for any tax credits. Forget what my situation is – they don’t care that a bad economy, a major illness and two job losses, one of which resulted in gross underemployment, has led to a growing pile of bills. They don’t ask those kinds of questions. They don’t care. So I click on one of the two options remaining in IL, and I call Assurant. Sure, they can get me something for under $200 a month, but it won’t cover any pre-existing conditions. Wait, wha??? I thought that was part of the reform!?! Only if you go with the ACA plans! This fixed coverage won’t pay for much, certainly not major med if something happens, and since it’s not one of ACA plans, I’ll have to pay a penalty for using it. WHAT?! Oh, yes! There is a penalty, I was told by the nice lady at Assurant. Is this something you’ve read about anywhere? I’ve read that people will face a penalty if they have NO insurance, but I can’t seem to find anything about a penalty if they opt to go with a cheap plan outside of the ACA plans.

Now, how in God’s name are we supposed to pay for a government insurance policy that costs so much money we cannot afford it, yet if we don’t go that route we’ll be penalized anyway? If I was once considered middle class, and I’m struggling, how the heck will those who couldn’t afford healthcare before suddenly be able to afford it now?

I know it says there are exceptions and that people who face financial hardships will be excluded from penalties, but guess what? My hardships are never hard enough, apparently. I never qualify for any kind of aid or assistance or help of any kind. I guess it’s time I start considering filing bankruptcy since I’m losing faith. I long ago lost the hope Obama had the audacity to pedal.

AskMarion~

Related: 

Attention Main Stream Media. Regarding Obamacare… I Told You So! 

GOP Senators’ Obamacare Replacement Beneficial to Young People says Senator Colborn as He Loses His Own Cancer Doctor in the Midst of His Cancer Fight 

Pray For Jim Hoft Over At Gateway Pundit

 

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